Alcohol use disorder (AUD) causes immense global burden and has a significant impact on economic and societal functioning. Efficacious treatments for AUDs have been well-established within the literature, however the most commonly accessed treatments for AUD are alcohol-related services, such as self-help groups, outpatient clinics, and detoxification centers. Though studies suggest these services are effective at treating AUDs, there are numerous differences between individuals who receive alcohol-related services and individuals who do not, causing selection bias. Furthermore, current studies of alcohol-related services frequently define recovery outcomes as abstinence, which reduces variability in viable recovery outcomes, such as reduction of drinking behaviors. In addition, reduction in drinking and alcohol-related problems should theoretically have an impact on broader aspects of functioning, such as familial functioning. Improved familial context may reduce risk to family members, who are otherwise at heightened risk for emotional and behavioral problems when living with a family member with AUD. The current study investigated the effect of alcohol-related services on binary and continuous drinking outcomes after eliminating selection bias using multiple propensity score approaches, to identify the best methodology for a high-risk community sample of individuals with AUD. Propensity scores were created using logistic regression approaches and boosted regression trees. Matching, weighting, and subclassification were used, and matching was performed both using greedy and global approaches. Results suggested subclassification was the most successful method for real world alcohol-related services samples with moderate sample size. Moreover, findings demonstrated that boosted regression approaches were less successful than logistic regression approaches at minimizing the effects of selection bias on known confounding variables that are highly related to group selection. In addition, after removing the effects of selection bias, there were no significant difference between participants who received alcohol-related services and the comparison control group on drinking or family functioning, though both groups reduced drinking from pre- to post-alcohol-related services receipt. Findings suggest careful selection of quasi-experimental methods is warranted in real-world samples, to ensure optimal removal of selection bias. Moreover, future studies should continue to clarify the profile of individual that benefits from alcohol-related services to inform intervention efforts.

The present study aimed to test the effect of role socialization processes on declines in drinking after marriage. Role socialization as it relates to marriage theorizes that after occupying a role, individuals are likely to change their behaviors to conform to role expectations of marriage, such as reductions in drinking (Yamaguchi & Kandel, 1985). Previous literature has examined declines in drinking behaviors after marriage and inferred that role socialization was the underlying process. This study is the first to directly test whether beliefs that alcohol is harmful to the marital role predicted declines in frequency of drunkenness after marriage. Ordered probit regression was used to test the effect of marriage-related motives to limit drinking on declines in frequency of drunkenness from before marriage to after marriage. Analyses revealed that marriage-related motives to limit drinking were not significantly predictive of declines in frequency of drunkenness after marriage. Only partner drinking emerged as a significant predictor of declines in frequency of drunkenness after marriage. These results highlight the need for a reliable and valid measure of role socialization processes as they relate to the marital role. Furthermore, future studies should consider studying participants at different time points after marriage and consider measuring commitment to the marital role as a moderator. Such studies will help to better understand the results of this study as well as better understand the marriage effect on drinking.